The AMA and 33 other specialty societies want CMS to bring consultation billing back.
The results of an AMA survey (pdf) show the consult change at the beginning of the year had a negative impact on physician balance sheets during the first few months of the year. About 72% of physician respondents reported revenues declined by more than 5%.
This is significant because CMS predicted after the consult change specialties would not experience decreases of more than 3%, the AMA says. But the survey says 12% saw decreases in revenue of more than 20% and 18% have had revenue declines of 15% to 20%.
This has caused some practices to reduce the number Medicare patients they treat (20%) and eliminate staff (34%).
A June letter from the AMA (pdf) says:
A review of CMS's current policies regarding physician consultations is clearly called for. Revenue losses for consultant physicians are larger than projected. Physicians have been forced to reduce services to Medicare patients and care coordination has suffered as a result of the policy. These problems could be mitigated by revising CMS guidelines regarding prolonged visits and new patients and/or by creating some mechanism for reimbursing consultant physicians for a comprehensive report back to a referring physician. We ask that CMS confirm in its proposed Medicare Physician Fee Schedule Rule for 2011 that it will address this issue in the final rule and we would welcome a chance to discuss the issue further.
I didn't see anything consult related in the proposed rule. So, I'm checking to see if CMS has a response to the AMA survey.